Syphilitic aseptic meningitis is a complication of untreated syphilis that involves inflammation of the tissues covering the brain and spinal cord. The condition is marked by changes in mental status and problems with nerve function.

Alternative Names:

Meningitis - syphilitic

Causes, incidence, and risk factors:

Syphilis is a sexually transmitted, infectious disease caused by the spirochete Treponema pallidum. Syphilis has three main stages: primary syphilis, secondary syphilis, and tertiary syphilis.

Syphilitic aseptic meningitis is a form of meningovascular neurosyphilis , which is a progressive, life-threatening complication of syphilis infection.

The disorder resembles meningitis caused by other conditions. There is inflammation of the meninges (the membranes that cover the brain and spinal cord). This may cause headaches , cognitive changes, or decrease in nerve functions such as vision, movement, or sensation. Vascular (blood vessel) symptoms, such as stroke secondary to syphilis, commonly accompany or follow syphilitic aseptic meningitis.

Risks of syphilitic aseptic meningitis include previous infection with syphilis or other sexually transmitted diseases such as gonorrhea (which may hide symptoms of syphilis infection). Syphilis infections are transmitted primarily through sexual contact with an infected person, but they may sometimes be transmitted by nonsexual contact.

An examination may indicate meningitis. There may be focal neurologic deficits (localized loss of nerve functions). A neurologic examination may show reduced cranial nerve function, including the nerves that control eye movement.

The goals of treatment are to cure the infection and stop the disorder from getting worse. Treatment of the infection reduces new nerve damage and may reduce symptoms, but it does not cure existing damage.

Penicillin or other antibiotics (such as tetracycline or erythromycin) are given to treat the infection. Treatment may be prolonged to ensure that the infection is completely cleared. Symptoms may improve dramatically after treatment. A follow-up examination of the cerebrospinal fluid is required to evaluate the effectiveness of the antibiotic therapy.

Symptomatic treatment is required for existing neurologic damage. Emergency treatment of seizures may be required! Anticonvulsants such as phenytoin may be needed to control seizures.

Assistance or supervision may be needed if the person is unable to function in self-care activities (eating, dressing, etc.). Confusion and other mental changes may improve or be prolonged after antibiotic treatment.

Support Groups:

Expectations (prognosis):

A progressive disability is possible. Early death is common, with death caused directly by the neurologic damage (resulting in decreased function of body systems) or by cardiovascular damage that also occurs with late syphilis infections.

People with late syphilis infections are at a greater risk for other infections and diseases. A seizure disorder can arise after infection.

Complications:

Inability to care for self

Inability to communicate or interact

Injury caused during seizures

Stroke secondary to syphilis

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if seizures occur.

Call your health care provider if severe headache with fever or other symptoms are present, particularly if there is a known history of syphilis infection.